Student Information 

    Emergency Contact

    Waiver of Liability (Required to take classes)

    As a participant in any program or class of Rose Empire Dance, I recognize and acknowledge there are certain risks of physical injury, and I agree to assume the full risk of injuries, including death, damages or loss that I or my minor child may sustain as a result of participating in any activities connected with or associated with such program or class. 
    I agree to waive and relinquish all claims I or my minor child may have as a result of participating in any program or class against Rose Empire Dance and its officers, agents, servants, employees and independent contractors. 
    I further agree to indemnify and hold harmless and defend Rose Empire Dance and its officers, agents, servants, employees and independent contractors from my claims resulting from injuries including death, damages and losses sustained by me or my minor child that arise out of, in connection with, or in any way associated with the activities of this program.
    COVID-19 UPDATED INFORMATION
    HEALTH AND SAFETY 
    • I confirm I do not have any symptoms related to and have not been knowingly exposed to COVID-19
    • If the above status changes, I agree not to attend classes at Bellywood Dance Studio.

    FACE COVERING
    • We are encouraging students to wear masks to classes, however it is not currently a requirement.

    SOCIAL DISTANCING
    • I agree to keep 6 feet between myself and other students while in the studio.

    CLEANLINESS
    • I agree to disinfect all props after use.
    • I agree to keep my hands washed/sanitized while at the studio.
    Electronically Signed forms must be submitted to prior to your first class.  Thank you.